Midodrine in chylothorax

Q: Midodrine can be used as an adjuvant treatment in chylothorax?

A) True

B) False

Answer: A

Although limited to case reports, there is weak evidence to utilize midodrine in chylothorax, particularly when the cause is idiopathic or in postoperative, high-output chylothorax. Midodrine, due to its alpha 1-adrenergic agonist property, causes vasoconstriction of the lymph system and reduces chylothorax. Midodrine can be used as a last resort if other standards of chylothorax treatments fail like dietary modifications or surgical intervention.

#pulmonary

References:

1. Liou DZ, Warren H, Maher DP, et al. Midodrine: a novel therapeutic for refractory chylothorax. Chest 2013; 144:1055.

2. Sivakumar P, Ahmed L. Use of an Alpha-1 Adrenoreceptor Agonist in the Management of Recurrent Refractory Idiopathic Chylothorax. Chest 2018; 154:e1.